Nursing Gastrointestinal Assessment

Isn't the GI system just our favorite? I have realized that the ICU is full of GI. Don't sign up for my specialty unless you are ready for lots of secretions and poop! Between the tube feeds and antibiotics almost everyone has diarrhea. I'll go through a more "normal" assessment than I usually see at the end of this section.

Assess bowel sounds. Are they present, hyperactive, hypoactive, or absent? What is the patient's diet order? Are they having any nausea or vomitting? Do they have an nasogastric (NG) tube or gastrostomy tube (G tube)? If he has tube feeds infusing, what have the residuals been? (Residuals are checked by putting a 50 mL syringe into the NG tube and pulling back whatever contents are in the stomach.) When was their last bowel movement? What did this look like? Do they have a colostomy or ileostomy?

Example assessment: This patient has present bowel sounds. He had nausea at 0930 which I treated with 4 mg of Zofran. His emesis was a small amount of bile. The Zofran helped to relieve his nausea. His last bowel movement was yesterday. He has an NG tube with tube feeds infusing. His tube feeds are Impact Peptide at 60 ml/hr which is the goal. He has 30 ml water flushes every four hours through his NG tube. His residuals have been 5-10 mL when I checked them every four hours.